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Home / Equine Research Bank / Open Vet J / Percutaneous ultrasonic debridement of equine tendinopathy a...
Open veterinary journal2023; 13(9); 1141-1149; doi: 10.5455/OVJ.2023.v13.i9.10

Percutaneous ultrasonic debridement of equine tendinopathy and desmopathy: A report of 10 cases.

Abstract: Tendinopathy and desmopathy are significant causes of morbidity in horses. To evaluate the use of percutaneous ultrasonic debridement (PUD) as a treatment for chronic tendinopathy and desmopathy in the horse. Eight adult horses with 10 affected limbs presented for lameness, ranging from 60-700 days postinjury. Diagnostic ultrasound identified the following: suspensory branch desmitis ( = 1), suspensory body desmitis ( = 2), Achilles tendinopathy ( = 1), desmitis of the accessory ligament of the deep digital flexor (DDF) tendon ( = 1), DDF tendinopathy ( = 2), and superficial digital flexor tendinopathy ( = 3). All horses had demonstrated lameness ranging from grade 1 to 4 [American Association of Equine Practitioners (AAEP) scale], with a mean pretreatment grade of 2.7. All horses underwent PUD using the Tenex Health TX System. Follow-up results were available from 6 to 41 months (mean, 23.2 months). Follow-up ultrasound imaging demonstrated improvement in fiber alignment and architectural change in all cases. All horses had a reduction in lameness from the treated tendon or ligament (AAEP grade 0-1; mean AAEP grade, 0.2) following a single treatment; lameness completely resolved in 8 of 10 treated limbs. No adverse events occurred in any case. No horses in this study developed a recurrence of their original lesion. Horses in this study demonstrated improvement following the PUD procedure. The procedure was well-tolerated and safe. Removal of tendinopathic scar tissue with PUD resulted in a return to function and without recurrence of the original lesion in all horses.
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Publication Date: 2023-09-30 PubMed ID: 37842115PubMed Central: PMC10576587DOI: 10.5455/OVJ.2023.v13.i9.10Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research study involves the treatment of chronic tendinopathy and desmopathy in horses through the technique of percutaneous ultrasonic debridement (PUD). The study involved ten cases, and post-treatment follow-ups showed improvement in all cases, with complete resolution of lameness in eight out of ten treated limbs.

Research Objective

  • The primary objective of this study was to assess the effectiveness of percutaneous ultrasonic debridement (PUD), as a treatment method for chronic tendinopathy and desmopathy in horses. These ailments are significant causes of morbidity in horses and require effective treatment methods to reduce the discomfort they bring.

Methodology

  • The researchers examined eight adult horses that had succumbed to tendinopathy and desmopathy. These horses, with a total of ten affected limbs, were diagnosed with ailments like suspensory branch desmitis, Achilles tendinopathy, desmitis of the accessory ligament of the deep digital flexor (DDF) tendon, and superficial digital flexor tendinopathy.
  • The lameness in these horses, measured on a scale given by the American Association of Equine Practitioners (AAEP), ranged from grade 1 to 4 with an average pretreatment grade of 2.7.
  • All horses were treated using PUD with the Tenex Health TX System, without any adverse events in any of the cases.

Results

  • Follow-up results, available from 6 to 41 months (average of 23.2 months), demonstrated an improvement in fiber alignment and architectural change in all cases.
  • All treated horses saw a reduction in their lameness to an AAEP grade of 0-1 (average AAEP grade of 0.2) following just a single treatment. There was a complete resolution of lameness reported in eight out of ten treated limbs.
  • None of the horses in the study developed a recurrence of their original lesion.

Conclusion

  • Percutaneous ultrasonic debridement, as used in this study, proved successful in treating tendinopathy and desmopathy in horses. The procedure was well-tolerated and safe. Also, its application led to the removal of tendinopathic scar tissue and enabled a return to function.
  • The study offers promising implications for the use of PUD to treat inflammatory disorders in ligaments and tendons of horses.

Cite This Article

APA
Vlahos TP. (2023). Percutaneous ultrasonic debridement of equine tendinopathy and desmopathy: A report of 10 cases. Open Vet J, 13(9), 1141-1149. https://doi.org/10.5455/OVJ.2023.v13.i9.10

Publication

Open veterinary journal
ISSN: 2218-6050
NlmUniqueID: 101653182
Country: Libya
Language: English
Volume: 13
Issue: 9
Pages: 1141-1149

Researcher Affiliations

Vlahos, Ted P
  • Yellowstone Equine Hospital, PC, 356 W. Yellowstone Avenue, Cody, Wyoming 82414, USA.

MeSH Terms

  • Horses
  • Animals
  • Debridement / veterinary
  • Lameness, Animal / therapy
  • Lameness, Animal / etiology
  • Achilles Tendon / pathology
  • Ultrasonics
  • Tendinopathy / therapy
  • Tendinopathy / veterinary
  • Horse Diseases / surgery
  • Horse Diseases / diagnosis

Conflict of Interest Statement

The author declares that his spouse is a distributor for Tenex Health.

References

This article includes 37 references
  1. Abate M, Gravare-Silbernaglek K, Siljeholm C, Dilorio A, DeAmicis D, Salini V, Werner S, Paganelli R. Pathogenesis of teninopathies: inflammation or degeneration?. Arthritis Res Ther 2009;11(3):235.
    pmc: PMC2714139pubmed: 19591655
  2. Avella C, Smith R. Diagnosis and management of tendon and ligament disorders. In: Auer J.A, Stick J.A, editors. In Equine surgery. 4th. St. Louis, MO: Elsevier; 2012. pp. 1157–1179.
  3. Barnes D. Ultrasonic energy in tendon treatment. Oper. Tech. Orthop. 2013;23:78–83.
  4. Barnes D, Beckley J.M, Smith J. Percutaneous ultrasonic tenotomy for chronic elbow tendinosis: a prospective study. J. Shoulder Elbow Surg. 2015;24:67–73.
    pubmed: 25306494
  5. Clegg P.D. Musculoskeletal disease and injury, now and in the future. Part 2: Tendon and ligament injuries. Equine Vet. J. 2012;44:371–375.
    pubmed: 22486548
  6. Dakin S.G. A review of the healing process in equine superficial digital flexor tendon tendinopathy. Equine Vet. Educ. 2016;29:516–520.
  7. Dakin S.G, Dudhia J, Smith R.K.W. Resolving an inflammatory concept: the importance of inflammation and resolution in tendinopathy. Vet. Immunol. Immunopathol. 2014;15:121–127.
    pmc: PMC3991845pubmed: 24556326
  8. Dowling B, Dart A, Hodgson D, Smith R.K.W. Superficial digital flexor tendonitis in the horse. Equine Vet. J. 2000;32:369–378.
    pubmed: 11037257
  9. Dyson S.J. Medical management of superficial digital flexor tendonitis: a comparative study in 219 horses (1992-2000). Equine Vet. J. 2004;36:415–419.
    pubmed: 15253082
  10. Dyson S, Murray R. Management of hindlimb proximal suspensory desmopathy by neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy: 155 horses (2003-2008). Equine Vet. J. 2012;44:361–367.
    pubmed: 21883416
  11. Elattrache N, Morrey B. Percutaneous ultrasonic tenotomy as a treatment for chronic patellar tendinopathy-jumper’s knee. Oper. Tech. Orthopedics. 2013;23(2):98–103.
  12. Ely E.R, Avella C.S, Price J.S, Smith R.K, Wood J.L, Verheyen K.L. Descriptive epidemiology of fracture, tendon and suspensory ligament injuries in national hunt racehorses in training. Equine Vet. J. 2009;41:372–378.
    pubmed: 19562899
  13. Freed L, Ellis M.B, Johnson K, Haddon T. Fasciotomy and surgical tenotomy for chronic achilles insertional tendinopathy: a retrospective study using ultrasound-guided percutaneous microresection. JAPMA 2019;109(1):1–8.
    pubmed: 30964321
  14. Hogan P.M, Bramlage L.R. Transection of the accessory ligament of the superficial digital flexor tendon for treatment of tendinitis: long term results in 61 standardbred racehorses (1985-1992). Equine Vet. J. 1995;27(3):221–226.
    pubmed: 7556050
  15. Hu A.J, Bramlage L.R. Racing performance of Thoroughbreds with superficial digital flexor tendonitis treated with desmotomy of the accessory ligament of the superficial digital flexor tendon: 332 cases (1989-2003). J. Am. Vet. Med. Assoc. 2014;244(12):1441–1448.
    pubmed: 24871068
  16. Kamineni S, Butterfield T, Sinai A. Percutaneous ultrasonic debridement of tendinopathy—a pilot Achilles rabbit model. J. Orth. Surg. Res. 2015;10:70.
    pmc: PMC4490679pubmed: 25986341
  17. Kamineni S, Ruggles A, Hamza A. Ultrasonic debridement with stem cell therapy of suspensory branch desmitis in an equine patient. Open Vet. J. 2019;9(1):54–57.
    pmc: PMC6500858pubmed: 31086767
  18. Kashashima Y, Takahashi T, Smith R.K.W, Goodship A.E, Kuwano A, Ueno T, Hirano S. Prevalence of superficial digital flexor tendonitis and suspensory desmitis in Japanese Thoroughbred flat racehorses in 1999. Equine Vet. J. 2004;36:346–350.
    pubmed: 15163043
  19. Kelman C.D. The history and development of phacoemulsification. Int. Ophthalmol. Clin. 1994;34(2):1–12.
    pubmed: 8071012
  20. Koh J.S, Mohan P.C, Howe T.S, Lee B.P, Chia S.L, Yang Z, Morrey B.F. Fasciotomy and surgical tenotomy for recalcitrant lateral elbow tendinopathy; early clinical experience with a novel device for minimally invasive percutaneous microresection. Am. J. Sports Med. 2013;41:636–644.
    pubmed: 23302261
  21. Morrey B.F. Ultrasonic percutaneous tenotomy for chronic refractory tendinopathy. In: Morrey B.F, Sanchez-Sotelo J, Morrey M.E, editors. In Morrey’s the elbow and its disorders. 5th. St. Louis, MO: Elsevier; 2017. pp. 582–587.
  22. Morrey B.F. A new safe and effective treatment for chronic refractory tendinopathy. Orthop. Rheum. Open Access J. 2018;11(5):1–5.
  23. Morrey B.F. Percutaneous ultrasound tenotomy for epicondylitis. In: Morrey B.F, editor. In Master’s techniques in orthopedic surgery: the elbow. 3rd. Philadelphia, PA: Wolters Kluwer Health; 2014. pp. 339–346.
  24. Nanos K.N, Malanga G.A. Treatment of patellar tendinopathy refractory to surgical management using percutaneous ultrasonic tenotomy and platelet rich plasma: a case presentation. PMR 2015;7(12):1300–1305.
    pubmed: 26146192
  25. O’Brien C, Marr N, Thorpe C. Microdamage in the equine superficial digital flexor tendon. Equine Vet. J. 2021;53:417–430.
    pubmed: 32772396
  26. O’Daly B.J, Morris E, Gavin G.P, O’Byrne J, McGuinness G.B. High-power low-frequency ultrasound: a review of tissue dissection and ablation in medicine and surgery. J. Mater. Process. Technol. 2009;200(1-3):38–58.
  27. Ostrom E, Joseph A. Percutaneous ultrasound tenotomy using the Tenex System on the adductor longus tendon: a pilot case series. MOJ Sports Med. 2018;2(1):00035.
  28. Patel M.M. A novel treatment for refractory plantar fasciitis. Am. J. Orthop. 2015;44:107–110.
    pubmed: 25750942
  29. Patel M, Patel S.M, Patel S, Daynes J. A pilot study of a novel treatment method for refractory painful plantar fibromas. Austin. J. Orthopaed. Rheumatol. 2015;2(2):1014.
  30. Plevin S, McLellan J. The effect of insertional suspensory branch desmitis on racing performance in juvenile thoroughbred racehorses. Equine Vet. J. 2014;46(4):451–457.
    pubmed: 23937263
  31. Ribitsch I, Oreff G.L, Jenner F. Regenerative medicine for equine musculoskeletal diseases. Animals 2021;11(1):234.
    pmc: PMC7832834pubmed: 33477808
  32. Richardson L.E, Dudhia J, Clegg P.D, Smith R. Stem cells in veterinary medicine-attempts at regenerating equine tendon after injury. Trends Biotechnol. 2007;25:409–416.
    pubmed: 17692415
  33. Seng C, Mohan P.C, Koh S.B, Howe T.S, Lim Y, Lee P, Morrey B. Ultrasonic percutaneous tenotomy for recalcitrant lateral elbow tendinopathy: Sustainability and sonographic progression at 3 years. Am. J. Sports Med. 2016;44(2):504–510.
    pubmed: 26602153
  34. Thorpe C.T, Clegg P.D, Birch H.L. A review of tendon injury: why is the equine superficial digital flexor tendon most at risk?. Equine Vet. J. 2010;42:174–180.
    pubmed: 20156256
  35. Tnibar A. Ultrasound-aided tendon and ligament surgery in the horse. Equine Vet. Ed. 2007;19(8):435–443.
  36. Walrod B, Turner W, Pauls K. Rapid and successful rehabilitation and return to play for a D1 gymnast after treatment of lateral epicondylitis with ultrasound guided percutaneous tenotomy (Tenex). Am. J. Sports Sci. 2020;5(1):1–4.
  37. White N.A, Hewes C.A. Treatment of suspensory ligament desmopathy. Proc. Am. Assoc. Equine Pract. 2008;54:502–507.

Citations

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